[Transfusion policy in trauma involving massive blood loss]. / Transfusiebeleid bij trauma met massaal bloedverlies.

ABSTRACT

Severe haemorrhage is a significant cause of death in trauma patients. In the case of massive blood loss a combination of coagulation defects, acidosis and hypothermia arise, which are accompanied by high morbidity and mortality rates unless properly corrected. Research in wounded military showed that a high ratio of fresh frozen plasma to packed red blood cells (FFPPRBC) seemed to have a positive effect on survival. These studies do not provide a definition of the ideal ratio FFPPRBC; the ratio in which a positive effect is seen varies from 11 to 13. Unnecessary FFP transfusions in trauma patients without imminent severe haemorrhage increase the risk of complications such as multi-organ failure and acute respiratory distress syndrome. Additional research is required into the accuracy of diagnosis of acute coagulation disorders.